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. 2016 Apr;103(4):1033-44.
doi: 10.3945/ajcn.115.120873. Epub 2016 Feb 10.

Vitamin D deficiency in Europe: pandemic?

Kevin D Cashman  1 , Kirsten G Dowling  2 , Zuzana Škrabáková  2 , Marcela Gonzalez-Gross  3 , Jara Valtueña  4 , Stefaan De Henauw  5 , Luis Moreno  6 , Camilla T Damsgaard  7 , Kim F Michaelsen  7 , Christian Mølgaard  7 , Rolf Jorde  8 , Guri Grimnes  8 , George Moschonis  9 , Christina Mavrogianni  9 , Yannis Manios  9 , Michael Thamm  10 , Gert Bm Mensink  10 , Martina Rabenberg  10 , Markus A Busch  10 , Lorna Cox  11 , Sarah Meadows  11 , Gail Goldberg  11 , Ann Prentice  11 , Jacqueline M Dekker  12 , Giel Nijpels  13 , Stefan Pilz  14 , Karin M Swart  12 , Natasja M van Schoor  12 , Paul Lips  15 , Gudny Eiriksdottir  16 , Vilmundur Gudnason  17 , Mary Frances Cotch  18 , Seppo Koskinen  19 , Christel Lamberg-Allardt  20 , Ramon A Durazo-Arvizu  21 , Christopher T Sempos  22 , Mairead Kiely  23
Affiliations

Vitamin D deficiency in Europe: pandemic?

Kevin D Cashman et al. Am J Clin Nutr. 2016 Apr.

Abstract

Background: Vitamin D deficiency has been described as being pandemic, but serum 25-hydroxyvitamin D [25(OH)D] distribution data for the European Union are of very variable quality. The NIH-led international Vitamin D Standardization Program (VDSP) has developed protocols for standardizing existing 25(OH)D values from national health/nutrition surveys.

Objective: This study applied VDSP protocols to serum 25(OH)D data from representative childhood/teenage and adult/older adult European populations, representing a sizable geographical footprint, to better quantify the prevalence of vitamin D deficiency in Europe.

Design: The VDSP protocols were applied in 14 population studies [reanalysis of subsets of serum 25(OH)D in 11 studies and complete analysis of all samples from 3 studies that had not previously measured it] by using certified liquid chromatography-tandem mass spectrometry on biobanked sera. These data were combined with standardized serum 25(OH)D data from 4 previously standardized studies (for a total n= 55,844). Prevalence estimates of vitamin D deficiency [using various serum 25(OH)D thresholds] were generated on the basis of standardized 25(OH)D data.

Results: An overall pooled estimate, irrespective of age group, ethnic mix, and latitude of study populations, showed that 13.0% of the 55,844 European individuals had serum 25(OH)D concentrations <30 nmol/L on average in the year, with 17.7% and 8.3% in those sampled during the extended winter (October-March) and summer (April-November) periods, respectively. According to an alternate suggested definition of vitamin D deficiency (<50 nmol/L), the prevalence was 40.4%. Dark-skinned ethnic subgroups had much higher (3- to 71-fold) prevalence of serum 25(OH)D <30 nmol/L than did white populations.

Conclusions: Vitamin D deficiency is evident throughout the European population at prevalence rates that are concerning and that require action from a public health perspective. What direction these strategies take will depend on European policy but should aim to ensure vitamin D intakes that are protective against vitamin D deficiency in the majority of the European population.

Keywords: 25(OH)D; Europe; prevalence; standardized; vitamin D deficiency.

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References

    1. Holick MF. The vitamin D deficiency pandemic and consequences for nonskeletal health: mechanisms of action. Mol Aspects Med 2008;29:361–8. - PMC - PubMed
    1. Grant WB, Cross HS, Garland CF, Gorham ED, Moan J, Peterlik M, Porojnicu AC, Reichrath J, Zittermann A. Estimated benefit of increased vitamin D status in reducing the economic burden of disease in western Europe. Prog Biophys Mol Biol 2009;99:104–13. - PubMed
    1. Seamans KM, Cashman KD. Existing and potentially novel functional markers of vitamin D status: a systematic review. Am J Clin Nutr 2009;89:1997S–2008S. - PubMed
    1. Sempos CT, Vesper HW, Phinney KW, Thienpont LM, Coates PM. Vitamin D status as an international issue: national surveys and the problem of standardization. Scand J Clin Lab Invest Suppl 2012;243:32–40. - PubMed
    1. Cashman KD, Kiely M. Towards prevention of vitamin D deficiency and beyond—knowledge gaps and research needs in vitamin D nutrition and public health. Br J Nutr 2011;106:1617–27. - PubMed

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